AC Joint Separation

AC Joint Separation Overview

A common injury among physically active individuals, an AC joint separation is not truly an injury to the shoulder joint. A separated shoulder involves the acromioclavicular joint, more commonly known as the AC joint. In an AC separation, the clavicle (collarbone) separates from the scapula (shoulder blade), commonly caused by a fall directly on the “point” of the shoulder or a direct blow to the shoulder area. Orthopedic shoulder specialist located in the greater Austin, Texas area, Dr. Jeff Padalecki specializes in the treatment of AC joint separations.

An AC separation is typically experienced when an individual falls directly on the “point” of the shoulder blade. The trauma from the fall is responsible for injuring the surrounding AC joint ligaments, including the acromioclavicular (AC) ligament and the two coracoclavicular (CC) ligaments. All three ligaments are responsible for stabilizing the AC joint.

An AC separation injury can range from a mild separated shoulder to a complete tear of both the AC ligament and CC ligaments. Many physicians range the injuries on a grade 1-6 scale, even though grades 1-3 are most commonly diagnosed.

Separated Shoulder Symptoms

A separated shoulder has a wide range of symptoms. The symptoms are dependent on the grade of injury.

  • Grade 1: A slight stretch or partially torn AC ligament may cause tenderness, skin bruising and minor to moderate shoulder pain.
  • Grade 2: A completely torn AC ligament and intact CC ligaments may cause moderate to severe shoulder pain, swelling, bruising and a small bump on the top of the shoulder.
  • Grade 3: Completely torn AC ligament and CC ligaments may cause severe shoulder pain, swelling, instability, shoulder deformity and popping sounds.

AC Joint Separation Diagnostic Testing

When the AC separation causes visible deformity, the shoulder injury is easy to diagnose. When deformity is not present, a thorough physical examination must be performed to locate the area of pain and to compare the injured arm to the uninjured arm. Dr. Padalecki will feel the bones and soft tissues in the injured area, evaluate the shoulder’s range of motion and perform tests to locate specific areas of pain and weakness during the examination. An MRI and X-rays may also be performed to determine the extent of injury and confirm the diagnosis.

Separated Shoulder Treatment

Separated shoulder treatment depends on the injury grade. Many patients will experience a full recovery with non-operative treatment measures such as rest, ice, shoulder immobilization, pain and anti-inflammatory medications and a physical therapy program in grade 1-3 cases.

Surgery may be recommended by Dr. Padalecki if the AC joint separation is too severe, grade 3 or higher, or if non-operative treatment measures do not alleviate the symptoms. A variety of surgical measures may be used. The most common technique involves the reconstruction of the CC ligaments and removing the shoulder end of the clavicle.

AC Joint Separation Post-Op

Following an AC separation surgery, patients will start shoulder motion under the direction of Dr. Padalecki and a therapist. Patients will be asked to wear a sling for protection for many weeks following surgery. Eventually, after the ligaments heal, patients will be allowed to progressively strengthen the shoulder joint and discard the sling. Return to sporting activities usually occurs around 3 to 4 months after surgery.

For additional information on an AC joint separation, or to learn more about treatment options for this shoulder injury, please contact Dr. Jeff Padalecki, orthopedic shoulder specialist in the greater Austin, Texas area. 

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